Racial and Ethnic Adult Disparities in Immunization Initiative READII

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Racial and Ethnic Adult Disparities in
Immunization Initiative (READII)
Tamara J. Kicera READII Project
Coordinator Immunization Services
Division National Immunization Program Centers
for Disease Control and Prevention
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Soliciting Public Input

• Difference between help with Implementation vs.
  Decision-Making
• READII projects were largely about engaging
  partners to implement intervention strategies
  known to be effective

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Overview

• Background on READII project
• Preliminary findings, lessons learned
• Next steps
• Rochesters Experience Key message
  starting/funding something new isnt always
  necessary

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Weve Been Busy!

• Project Genesis Spring 2002
• HHS Support July 31st announcement
• Partners engaged CMS, HRSA, AoA, AHRQ
• Funds awarded Demonstration sites began to
  identify stakeholders, Develop Community Plans

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Getting started

• State/local health departments had to obligate
  funds quickly
• Programs had little/no adult infrastructure in
  place
• Smallpox activities began Immunization/Health
  Department personnel asked to respond
• 2002-2003 Influenza season was upon us

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Whats happening

• Sites and Agencies have formed new, important
  partnerships Engaged their communities
• Infrastructure needs/gaps are better understood
• Evidence-based interventions are underway
• Evaluation efforts are planned to look at both
  outcome and process measures
• Formative research is generating ideas for
  targeted health education messages to patients
  and providers, including media campaigns
• READII activities have been widely publicized

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Provider Tool Kit
CDC Director Julie L. Gerberding holds up the
READII Provider Tool Kit at a press conference.
PHOTO CREDIT Evan Vucci--AP
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Whats happening (cont.)

• Sites and Agencies have formed new, important
  partnerships Engaged their communities
• Infrastructure needs/gaps are better understood
• Evidence-based interventions are underway
• Evaluation efforts are planned to look at both
  outcome and process measures
• Formative research is generating ideas for
  targeted media campaigns, health education
  messages to patients and providers
• READII activities have been widely publicized

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What are we learning?

• Every year presents new challenges!
• Duplicating childhood successes for adults may
  need new methods, interventions, partnerships
• Providers/Health Professionals attitudes about
  immunizing adults requires additional
  study/efforts
• Change of this magnitude takes time

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Mid-Course Review Meeting March 9-10, 2004 -
Goals

• To review and discuss successes and challenges
  thus far in the project with each other
• To allow discussion of issues and challenges with
  CDC, partners and invited panelists and
• To share site-specific project information with
  senior officials from HHS and other partners.

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Whats Next?

• Programmatic activities end December 31, 2004
  Evaluation activities begin in earnest January
  2005
• 2003-2004 flu season experience is presenting
  opportunities
• Sites experiences are/will be valuable to future
  efforts both programmatic and research efforts
• Dissemination of findings Replication?

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READII ROCHESTER

• Community Action Plan
• Christine Long, M.P.H.
• The Center for Rochesters Health
• A collaboration of the
• University of Rochester and the
• Monroe County Department
• of Public Health

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Outline

• Community Action Plan components
• Community Advisory Board
• Community Based Organizations
• Communications
• Targeted Projects
• Vaccine Providers
• Actions and Accomplishments
• Assessment

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READII RochesterCommunity Action Plan
Primary Care Practice Intervention
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Community Advisory Board Members

• Community Based Organizations
• Urban League of Rochester
• Ibero American Action League
• Economic development groups
• Senior Organizations
• Coalition of African American Churches
• Influenza vaccine providers
• Health care providers from Primary Care Sites
• Insurers, Medical Society, Primary Care Network
• Health Department immunization unit

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READII RochesterCommunity Action Plan Goal

• Messages endorsed by African American
  community
• Adult vaccines are important and needed
• Racial and ethnic disparities exist
• Direction on where and how to get vaccines

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Community Advisory Board

• Approved all intervention plans
• Made specific recommendations
• Use existing organizations to spread message on
  adult vaccines
• One to one, or small group format is best
• Be patient
• Volunteered their organizations
• Volunteered as speakers (churches,
• media)

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Community Based Organizations
CBOs provided Outreach and education to own
constituents e.g. foster grandparents, case
management clients, Head Start READII team
provided Low literacy cards and brochures
Training for CBO staff on culturally
competent delivery of vaccine information
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Community Based Organizations

• 23 staff from 12 CBOs participated in outreach
  training on adult vaccines and cultural
  competency
• 10 CBOs reported on activities
• Improvement needed
• Engage Hispanic American Community
• Engage more CBOs from other parts of city

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Communications
Summer campaign Any time of year is the
right time to talk to your doctor about
vaccines Television and newspaper
articles Fall campaign Protect your loved
ones, protect yourself Television and
newspaper articles Paid radio spots and
transit ads
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Lessons from the Community Action Plan

• Interpersonal approach worked best
• CBOs
• Church outreach
• Senior housing
• African Americans in Rochester did not respond
  to national media-created flu vaccine emergency
• Need to better evaluate media treatment of flu
  news and non-traditional communication strategies

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Lessons continued

• Success of Community Advisory Board linked to
  specific tasks, easily incorporated into usual
  activities
• Trusted members of community giving information
  about vaccines
• Low pressure education on vaccines

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Questions?